Claims Supervisor
Full Job Posting
Qualifications
- Qualifications • High school diploma or GED required • 5 years of claims processing experience required
- High school diploma or GED required
- 5 years of claims processing experience required
Responsibilities
- Job Duties & Responsibilities • Proactively identifies and solves problems with timely resolution of complex issues referred by Claims Examiners and Claims Benefits Specialists • Provides daily management support to Claims Examiners and Claims Benefits Specialists • Obtains daily stats of each team member’s production goals to review with Manager, and develops a successful plan to increase each team member’s production while maintaining accuracy • Responds to a claims processing question rapidly and accurately to meet the Claims Examiners and Claims Benefits Specialists expectations of timely processing of claims in queue via email or discussion. Resolves all questions on a daily basis accurately with a result of no pending claims or penalties • Monitors and audits specified criteria based on claims training to assure perception of policy and procedures guidelines was comprehended. Coordinates with trainer/manager a resolution to problems identified post training where a comprehension gap can be diminished • Assists the Manager with conducting performance reviews and team meetings • Assists Manager in identifying opportunities for process and service improvement initiatives, and participates in the development and implementation of action plans • Compiles and reviews Internal reports to identify any incorrect claims payment for all product lines for the weekly check run. Completes actual check review process and forwards for check process on same day as check push every week • Serves as initial point of contact for all issues regarding work schedules
- Job Duties & Responsibilities
- Proactively identifies and solves problems with timely resolution of complex issues referred by Claims Examiners and Claims Benefits Specialists
- Provides daily management support to Claims Examiners and Claims Benefits Specialists
- Obtains daily stats of each team member’s production goals to review with Manager, and develops a successful plan to increase each team member’s production while maintaining accuracy
- Responds to a claims processing question rapidly and accurately to meet the Claims Examiners and Claims Benefits Specialists expectations of timely processing of claims in queue via email or discussion. Resolves all questions on a daily basis accurately with a result of no pending claims or penalties
- Monitors and audits specified criteria based on claims training to assure perception of policy and procedures guidelines was comprehended. Coordinates with trainer/manager a resolution to problems identified post training where a comprehension gap can be diminished
- Assists the Manager with conducting performance reviews and team meetings
- Assists Manager in identifying opportunities for process and service improvement initiatives, and participates in the development and implementation of action plans
- Compiles and reviews Internal reports to identify any incorrect claims payment for all product lines for the weekly check run. Completes actual check review process and forwards for check process on same day as check push every week
- Serves as initial point of contact for all issues regarding work schedules
About Texas Children's Careers
Non-profit pediatric and maternal health system.
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